Yoga as a complementary intervention for polycystic ovary Syndrome management: a systematic review

Background Polycystic Ovary Syndrome (PCOS), a prevalent metabolic and reproductive disorder, significantly impacts women of reproductive age. The conventional approach offers various symptomatic pharmacological interventions for PCOS, but some of them have adverse effects too. In this context, yoga has emerged as a promising non-pharmacological complementary approach. Aim This systematic review aims to explore the therapeutic potential of yoga for managing PCOS with a focus on anthropometric, metabolic, endocrine, and psychological outcomes. Methods A systematic search was conducted across three databases i.e., PubMed, Web of Science and Scopus on 17.1.2025. Screening of articles was performed by two authors in two step process. Risk of Bias (RoB) of each study was assessed using Cochrane Risk of Bias version 2.0 (RoB 2). Due to high heterogeneity among studies in terms of type of intervention, duration, outcomes measured etc., meta-analysis could not be performed. Results Of the 303 studies initially identified, 9 randomized controlled trials (RCTs) met the inclusion criteria for the systematic review. However, four of these were conducted by the same research group and were considered as a single study in the analysis. Yoga interventions, such as asanas (physical postures) and pranayama (breathing exercises), demonstrated improvement in PCOS symptoms including anthropometric (weight, BMI, hip circumference), metabolic (insulin resistance, serum insulin, fasting blood glucose and lipid profile), endocrine (hirsutism, free testosterone, Anti-mullerian hormone, Luteinizing hormone, Dehydroepiandrosterone etc.), menstrual and psychological outcomes. Meditation and mindfulness-based interventions may help to improve mainly psychological symptoms such as body image, stress, anxiety, depression and quality of life etc. However, it is important to note that there were very few number of studies, that too with lots of heterogeneity, low sample size, diverse outcomes; therefore generalizability of this evidence are limited. Conclusion Yoga is a promising non-pharmacological complementary intervention for PCOS management that may offer diverse benefits for anthropometric, endocrine, metabolic and psychological health. However, further clinical trials with robust protocol, large sample size and standardized yoga protocol are essential to establish its long-term efficacy and integration into routine PCOS care. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261286708 , identifier CRD420261286708.